De Silva-Gutiérrez A, Osorio-Campos J, Arcos-Marcín M, Morales-Díaz J, Martínez-Méndez ME

Language: Spanish
References: 23
Page: 341-343
PDF size: 123.71 Kb.

ABSTRACT

A case of glans auto-amputation in a 47-year-old male is presented. The patient was being treated with haloperidol decanoate for schizophrenia and during a manicdepressive crisis he tied a cable in the form of a tourniquet around the glans penis groove. This produced necrosis of the glans, cutting through almost the entire circumference of the penis. The glans remained attached by a strip of spongy periurethral tissue and was then resected by a physician with a clean scissor cut. This particular case was an act of “self-punishment” in which the penis was strangulated until becoming necrotic and producing auto-amputation of the glans. In cases of strangulation, the degree of severity of damage from blood and lymphatic flow occlusion depends on the force used and the length of time involved. It is of the utmost importance for the physician to act quickly in order to avoid the irreversible damage of necrosis.

REFERENCES

1. Moufid K, Joual A, Debbagh A, Bennani S, El Mrini M. Genital Selfmutilation: report of 3 cases. Prog Urol 2004;14(4):540-3.

2. De Silva NA. Estrangulación Peneana. Presentación de un caso. Rev Mex de Urol 1996;56(4):159-60.

3. Sommerauer M, Walden O, Doehn C, Jocham D. Penile skin necrosis after application of a ring and defect coverage by a skin mesh graft. Aktuelle Urol 2006;37(5):376-8.

4. Voegeli TA, Effert PJ. Pentaethylene-terephthalate (PET) bottles: a new device for autoerotic strangulation of the penis causing serius injury. Arch Sex Behav 2005;34(4):469-70.

5. Patel C, Kim R, Delterzo M, Wang R. Prolonged penile strangulation with metal clamps. Asian J Androl 2006;8(1):105-6.

6. Schuster G, Stockmal P. Genital incarceration with metal rings: their safe removal. Tech Urol 1999;5(2):116-8.

7. Perabo FG, Steiner G, Albers P, Muller SC. Treatment of penile strangulation caused by constricting devices. Urology 2002;59(1):137.

8. Bhat Al, Kumar A, Mathur SC, Gangwal KC. Penile Strangulation. Br J Urol 1991;68(6):618-21.

9. Nazir Z, Rasheed K, Moazam F. Penile Constrictive band injury. J Pk Med Assoc 1993;43(7):135-7.

10. Maruschke M, Seiter H. Total infarction of the penis caused by entrapment in a plastic bottle. Urologe A 2004;43(7):843-4.

11. Mhiri MN, Midassi H, Mezghanni M, Smida ML. Strangulation of glans penis by hair or “penis tourniquet syndrome”. Pediatrie 1987;42(5):351-3.

12. Mat Saad AZ, Purcell EM, McCann JJ. Hair-thread tourniquet syndrome in an infant with bony erosion: a case report, literature review, and meta-analysis. Ann Plast Surg 2006;57(4):447-52.

13. Leferink VJ, Klaase JM. Toe tourniquet syndrome. Ned Tijischr Geneeskd 1997;141(51):2499-501.

14. Kuo JH, Smith LM, Berkowitz CD. A Hair tourniquet resulting in strangulation and amputation of the clitoris. Obstet Gynecol 2002;99(5 Pt 2):939-41.

15. Bacon Jl, Burgis JT. Hair thread tourniquet syndrome in adolecents: a presentation and review of the literature. J Pediatr Adolcesc Gynecol 2005;18(3):155-6.

16. Barnes S, Ben Caim J, Kessler A. Postcircumcision necrosis of glands penis:gray-scale and color doppler sonographic findings. J Clin Ultrasound 2007;35(2):105-7.

17. Sagar J, Sagar B, Shan DK. Penile skin necrosis-complication following selfcircuncision. Ann R Coll Surg Engl 2005;87(4):5-7.

18. Kim SJ, Chung H, Ahn HS, Chung DY, Kim YS. Strangulation of the penis by self-circumcision device. Urol Int 2002;68(3):197-8.